Here to Help

The flow of people seeking care didn’t stop for the Osteopathic medical students at
the Sonoma County Fairgrounds. It was day five of the North Bay fires, and the students
had just arrived at the evacuation center to volunteer. With their professors as preceptors,
the first and second year medical students had come to put their skills in Osteopathic
Manipulative Treatment to work. And there was plenty of work to do.

“I just wanted to keep them up and running, getting to do what they needed to do,”
says Donald Long, who before becoming a medical student had once worked through his
own fire evacuation as a hospital team lift supervisor in Paradise, CA.

Many Red Cross workers, firemen, and the members of the National Guard came in with
acute stiffness and pain.

Just a partition away was a woman who had been undergoing hospice care at her daughter’s
home, which they had just lost. Her grandchildren only wanted to watch over her as
she tried to rest on a metal cot.

One man wearing clothes that might have been given to him was sweating profusely on
the table, his skin red at the slightest touch. He had just lost his business.

Sarah Davis, a first year student who had previously spent seven years as an EMT examined
him with Long.

“Even the lightest touch made him react, and he said it caused him pain,” she explains.
“However, he supported his bodyweight on his injured shoulder several times without
incident, so we weren't suspicious of a significant injury there.”

He was too anxious to be touched and began to breathe rapidly, so Davis coached him
through deep breathing until he was calm, which he said made his shoulder pain subside.

“We just sat there and talked to him about what he had experienced. He had woken up
in the middle of the night and saw flames a block away from his apartment,” continues
Davis. “We were unable to do any treatment for him, but he said he did feel a little
better.”

One Person's Experience Evacuating

Kimberlee Walsh was woken up by the crack of a tree branch from the strong winds on
the night of the fires. She smelled smoke in the air coming from a window at her home
in the town of Sonoma. But the severity was clear when she let out her dogs at 6:00
am and received a text from a friend that “Santa Rosa was gone.” Walsh could see the
flames on the nearby hills and knew it was time to act.

By 6:45, she was at her local hardware store buying respirator masks. Walsh has severe
asthma. A cold or exposure to chemicals could put her in the hospital, and the smoke
was getting worse.

“The massive lines at the gas station in our small town felt like Armageddon,” she
says. “Still, we had no plan. We had no idea who could take us in.”

In addition to their six anxious pets, the Walsh’s also had to move her father-in-law
who has Parkinson’s and dementia. Walsh, her husband Sean, and daughter Shannon were
packed with photos off the walls, some clothes, and their wedding album by the time
that sheriffs came to enforce the evacuation.

They found refuge with family in Fremont. Out of his routine and in a strange place,
Walsh’s father-in-law experienced what she called “sundowning”, confusion and he had
fallen. In the wee hours of Wednesday morning, the 79-year-old man had got himself
fully dressed, thinking it was time to evacuate again.

Eight days later, they returned to a home that was untouched, but has suffered a lot
of smoke damage.

“We know 20 families that lost everything, including four very close friends,” reveals
Ms. Walsh. “Driving out of Sonoma to Napa I pass the rubble of the buildings that
used to be there. The neighborhoods in Santa Rosa where I would bring my children
as they grew up are just gone.”

Today, Ms. Walsh is gathering clothes to donate. Her daughter’s high school, Justin-Siena,
held its first day back and a prayer ceremony.

“It was incredibly frustrating to have to be away from helping others during the emergency
because of my asthma,” she continues. “But the love here is thicker than the smoke.
Signs are everywhere thanking the first responders.”

Commendation for Rising to the Occasion

Dr. Mohammed Jalloh, Assistant Professor of the College of Pharmacy, was commended
by Ole Health for working around the clock to arange for evacuees to receive the medications
that they had left behind. Jalloh stood in as clinical leader of the emergency operations
team, maintiaining clear records and ensuring that medication access was provided
"quickly and without hesitation".

Letters

I'm a Touro 2007 MPH, MSPAS grad. I'm currently working full time in Humboldt county
in vascular surgery and family practice. My rural home town of Salyer and Willow Creek
where my family practice clinic is located is routinely hit hard with wildfires, and
this year was no exception. We lost an entire small town about 25 miles away (Helena)
and dealt with 6 weeks of thick smoke. I operated a weekend clean air ctr. on the
weekend when the smoke was at its worst.

Given my experience, when the Santa Rosa fires hit, the experience hit home. With
two jobs, both in underserved areas, I didn't have much time to give. However, I was
able to carve out time to drive down for a 5pm-1am shift on day 7 after the fires
started. I worked at the Vets Ctr. in Santa Rosa. It was an eye opening experience.
I was put in charge of the isolation room as there was a diarrheal illness making
its way around the shelter. During my shift, it was decided by a higher up county
Public Health official that all the diarrheal cases must be shipped out to the ER
(despite the fact that the majority of them had waning symptoms were stabilized) in
fear that this was highly communicable and the rest of the shelter was at risk. It
was quite a night which ended in some lessons in communication with ER providers who
might not be taking into account that a disposition to a private home is much different
than a shelter.

Utilizing both my public health degree and my medical skills in this way was extremely
rewarding.

I believe educating medical and PA students in smoke inhalation related illnesses
and the interesting dynamics one encounters when involved in a domestic disaster such
as this one are incredibly important.

I’m 65 and have had asthma since infancy. I had no idea how debilitating exposure
to the smoke and particulate matter could be for me. I live along the river about
1.5 miles north of TU. I had to leave home on 10/12 because I was using a nebulizer
2-3 times daily and was getting less and less relief. I drove to Southern California
and stayed in the clear coastal air near family for a full week. Upon my return, I
was improved, but I continue to have asthma symptoms, a cough, and a very hoarse (but
now understandable) voice.

I now know that when the air quality reaches harmful and dangerous, I need to evacuate
sooner rather than later, and not depend on a ventilator mask to prevent an asthma
flare. Worth sharing with others, I hope.

Monica Tipton, MA, BCBAGraduate School of Education Class of 2010

Useful Knowledge After the Fires

According to CalFire.CA.Gov, over 245,000 acres have been burnt across the state since
Sunday, October 8th. An estimated 8,400 structures have been destroyed and 42 lives were lost in the
devastation.

The ashes of businesses and homes can contain hazardous metals and chemicals. Be careful
to avoid inhalation and skin contact with the ash. To avoid getting more ash back
in the air, use water and wet mops rather than sweeping. Vacuuming is also not recommended
unless using a vacuum with a HEPA filter.

Air pollution moves, but doesn’t vanish. Those living in an evacuated area and surrounding
areas may still need to take precautions and refer to AirNow.gov for current air quality
conditions.

Most importantly, listen to your body. If you notice that you are sensitive and that
your eyes, nose, and breathing zone are irritated, respond to that by staying inside.
For a list of symptoms, visit here.

Under normal circumstances air quality outdoors is typically healthier than the air
we have indoors, and it is good to open windows and ventilate indoor spaces. Moving
forward, we can all proactively take steps to improve our indoor air and to reduce our contribution to outdoor air pollution by reducing our use of energy
at home, at work and through our commute. For a list of detailed ideas, visit here.

Pay close attention to spare the air days, open your windows on good air days to reduce
your exposure to indoor air pollutants.

Boil water advisories and food safety recommendations have been issued for certain
areas. For more, visit here.

Essential Resources to Prepare for the Next Emergency

Don't be left wondering “What do I do?” in the next emergency.

Always seek out your county and city emergency resources to receive instruction and
monitor emergencies, such as the Solano County Office of Emergency Services at www.solanocounty.com/depts/oes/